Ductal Carcinoma In Situ (DCIS) Breast Cancer: Causes, Symptoms and Treatments

Ductal Carcinoma in Situ (DCIS) is a type of breast cancer in which the cancer cells remain confined to one place within the breast. 'In situ' literally means 'in place'.The cancerous growth is usually observed in the breast ducts. Ducts are tiny tubes that are responsible for bringing milk from where it is produced (in the lobules) to the nipple. The cancer cells that originate in the breast ducts do not have the ability to invade the tissues.

The term cancer brings to our mind a disease that spreads indiscriminately in the different organs of the body. However, in case of DCIS, the cancer cells stay inside the ductal system. At the most, the cancerous growth may spread and cover a large area of the breast. But the cancer cells do not move outside the duct or to other parts of the body.

DCIS also known as stage 0 cancer and is contained within the ductal system. This form of cancer is non invasive. Studies have shown that many women suffering from DCIS can lead a normal life for years, without any treatment. In fact, women with DCIS usually do not have any idea that they are living with this cancer. This happens because the DCIS sufferers do not show any symptoms.

Causes of DCIS

The exact causes of DCIS are still not known. However, certain women are at an increased risk of developing it. These include women who experienced a late menopause or women who started their periods very early in their life. Women with a family history of breast cancer are also susceptible to this condition.

Symptoms of DCIS

Most women suffering from DCIS do not show any signs or symptoms. However, a small percentage of women with DCIS may have a lump in the breast. Occasionally DCIS may cause a discharge of fluid from the nipple.

Diagnosis for DCIS

A test used to diagnose DCIS involves the usage of mammograms. Mammography is a procedure that uses low dose amplitude x-rays for examining the breast tissue. Microscopic breast changes associated with DCIS can be easily identified using mammography. Suspicious areas may contain calcium deposits known as microcalcifications, which can be easily detected through x-rays. For further evaluation, the doctor may recommend a breast biopsy. To confirm a suspected DCIS, a breast biopsy is performed in which a small sample of tissue is taken out and observed under the microscope. Biopsy can be done by either using a very small needle or a large needle, to remove a sample of breast tissue.

Treatment for DCIS

If left untreated, DCIS may progress to invasive cancer where the abnormal cells attack the breast tissue that are outside the duct. Although DCIS is not life-threatening, a careful medical treatment is required to cure the disease. The treatment depends on the size of the breast area affected by the cancerous growth. If the area is small, then doctors recommend lumpectomy, which involves removal of the cancerous mass and the healthy tissue surrounding it. This is called breast conserving surgery, in which only the area containing the cancer is removed. People undergoing this surgery experience minimal pain and within a week, they can resume their normal daily routine. However, if the cancerous growth is large or detected in several places throughout the breast, then doctors are likely to perform a breast removal surgery (mastectomy). This form of treatment cures all cases of DCIS. Many doctors also perform radiation therapy after lumpectomy. This is done to kill any remaining cancer cells.

If the doctor determines that the cancer cells are estrogen receptive (need estrogen for growth), then a drug, tamoxifen, is administered to prevent these cancer cells from absorbing the estrogen. The drug also helps reduce the possibility of developing an invasive form of cancer in the future.